NPIMap

Organization Active NPI

Pain Management & Treatment Center, S.C.

  • Specialist
  • Milwaukee, WI
National Provider Identifier
1750412201
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PAIN MANAGEMENT & TREATMENT CENTER, S.C.
Practice address
8901 N 76TH St
Milwaukee, WI 53223-1901
Phone
(414) 354-0772
Fax
(414) 365-0773
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jaison Thekkekara, MDNPI 1588015416
Title
Treasure
Phone
(972) 839-6292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

8901 N 76TH St
Milwaukee, WI 53223-1901

Mailing address

8901 N 76TH St
Milwaukee, WI 53223-1901
Phone (414) 354-0772

Other identifiers 1

IdentifierTypeStateIssuer
32896100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040202000063 WI Part B Supplier - Clinic/Group Practice 2062315419 Receives reassigned benefits from 11 practitioners
Practice locations: Milwaukee, WI
O20141113001867 WI DME Supplier - Physician - Interventional Pain Management 2062315419 Practice locations: Milwaukee, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2002830Pain Management Treatment Center SC8901 N 76TH St, Milwaukee, WI 53223AccreditationSep 11, 2026

National Provider Directory

National Provider Directory

Locations

8901 N 76th St
Milwaukee, WI 53223
Phone (414) 354-0772

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772755200000",
    "number": "1750412201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 N 76TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532231901",
            "telephone_number": "414-354-0772",
            "fax_number": "414-365-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 N 76TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532231901",
            "telephone_number": "414-354-0772",
            "fax_number": "414-365-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT & TREATMENT CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A",
        "authorized_official_last_name": "THEKKEKARA",
        "authorized_official_first_name": "JAISON",
        "authorized_official_title_or_position": "TREASURE",
        "authorized_official_telephone_number": "972-839-6292",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32896100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.